High IR-related insulin levels also promote Na+-H+ exchange in the renal tubules, enhance the excretion of H+, and favor the reabsorption of UA (39), while renin-angiotensin system activity in response to hyperinsulinemia leads to a drop in blood flow in the kidneys, greater urate reabsorption, and xanthine oxidase production that contribute to higher levels of SUA output (40), McCormick et al. Here, REN is linked to Hyperinsulinemia.